Surgery of cerebellar astrocytomas, ependymomas and medulloblastomas in children

Abstract

A report is given on 118 children operated on for cerebellar astrocytoma, ependymoma or medulloblastoma in 1968–1982. During the first period (1968–1975) when the diagnosis was based on ventriculography and the operation performed later on the same day, the surgical mortality was 5%, 22%, and 16% respectively in these tumours. In the period since 1976, during which the diagnosis was based on CT and preoperative shunting was routine with the posterior fossa operation performed a week later and an operation microscope was available, no surgical mortality occurred. In patients with ependymoma or medulloblastoma the shunt was left in permanently; in patients with astrocytoma the shunt was removed if the patient tolerated its closure. The prognosis for astrocytoma was excellent. The 10-year survival rate was 97%. The five-year survival rate for medulloblastoma was 27% and the 10-year survival rate 13% which are less than the rates generally reported. For ependymoma patients the prognosis was poor whatever the therapy.